Rotator cuff repair (arthroscopic)

Rehabilitation programme following arthroscopic rotator cuff repair, with strict early protection and a graduated return to overhead activity.

Typical timeframe: Return to sport from ~6 months (9 months for throwing)

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Phase 01 · Weeks 0 – 6

0 – 6 weeks after surgery

Wear sling when walking or travelling.
Otherwise remove sling with arm supported on a chair, table or pillow; the hand can be used for eating, computer and paperwork etc.
Don't move the shoulder too much.
3 times a day, wrist and hand exercises with a squeeze ball, but the arm must be kept internally rotated during these exercises.
Physiotherapy to teach isometric muscle contraction of deltoid and scapular stabilizers, elbow and hand movement.

Phase 02 · Weeks 6 – 12

6 – 12 weeks after surgery

No more sling, except if in a rowdy crowd situation.
Begin passive motion 0 – 90° forward flexion supine, and external rotation to neutral; no internal rotation beyond resting against the tummy.
No abduction for 4 months until all other movements are full — premature abduction whilst the shoulder is stiff (including abnormal scapulo-thoracic rhythm) can result in impingement.

Phase 03 · Weeks 12 – 16

Continue stretching of the shoulder.
Begin formal strengthening of internal and external rotation, retraining of scapulo-thoracic rhythm and proprioception.
Patient may walk / jog and swim (breaststroke only).

Phase 04 · Weeks 16 – 24

Obtain full range of motion slowly over 24 weeks.
Sports specific strength and endurance training (tennis overhead serve, freestyle swimming, surfing) when fully rehabilitated with respect to motion, strength and proprioception. This usually does not occur until 6 months — 9 months for throwing.

Last reviewed: 2025-10-15.